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This US Institute of Medicine (IOM) “report”:http://books.nap.edu/books/0309090776/html/index.html calls for increased Federal investment in a secure national healthcare information infrastructure in order to improve patient safety. If I recall correctly this is a major portion of the mandate for the “Internet 2 consortium”:http://www.internet2.edu/about/aboutinternet2.html. (“See the Health Sciences Security SIG”:http://health.internet2.edu/WorkingGroups/Security.html)

From the report:

“First, federal financial investment should support the development of critical building blocks of the national health information infrastructure that are unlikely to receive adequate support through investment by private-sector stakeholders, including the establishment of a secure platform for the exchange of data across all providers, and, as discussed below, maintenance of a process for the ongoing promulgation of national data standards. Second, the federal government should provide financial incentives to stimulate pnvate-sector investments in EHR systems; this might be done through revolving loans, differential payments to providers with certain information technology capabilities, or other means. Third, federal government funding of safety net providers will be necessary to support their transition to a safer health care delivery system.”

We should examine closely the long term effects of these financing arrangements. They are simply a quick fix to a problem that will out live the incentives. If these systems are held as proprietary applications they will serve to drive up the cost of healthcare when the funding runs out and the requiremetn to maintain them remains.

“Chapter 3”:http://books.nap.edu/books/0309090776/html/71.html#pagetop is especially important as it discusses the requirements for standards. What must be recognized here is that development of data interchange standards are in direct conflict with market share of proprietary shrink-wrapped applications.

This is a good and necessary report but it missed the basic requirement that the software must live beyond the funding cycle.